大黄联合益生菌治疗老年重度急性脑梗死的临床疗效研究

Clinical effects of rhubarb combined with probiotics in the treatment of elderly patients with severe acute cerebral infarction

目的探究大黄联合益生菌治疗对老年重度急性脑梗死患者肠道菌群、胃肠道功能、炎症指标及预后的影响。方法选取2020年1月—2021年12月收治的老年重度急性脑梗死患者128例,随机分为观察组(n=64)和对照组(n=64)。所有患者入组后接受心电监护与常规对症治疗。在此基础之上,对照组接受益生菌肠内营养支持,观察组接受益生菌肠内营养支持联合大黄治疗,2组均连续治疗4周。比较2组治疗前后的肠道菌群、胃肠道功能、炎症指标及预后情况。结果2组治疗前后双歧杆菌、乳杆菌、肠球菌和大肠杆菌的菌群数差值比较,差异有统计学意义(均P<0.001)。2组治疗前后降钙素基因相关肽和胃动素的差值比较,差异有统计学意义(均P<0.001)。2组治疗前后白介素-6、C反应蛋白和肿瘤坏死因子-α的差值比较,差异有统计学意义(均P<0.001)。2组美国国立卫生研究院脑卒中量表评分治疗前后的差值比较,差异有统计学意义(P<0.001)。结论大黄联合益生菌可能通过维持肠道菌群平衡、恢复胃肠道功能和减轻炎症反应等,改善老年重度急性脑梗死患者的预后。

Objective To explore the effects of rhubarb combined with probiotics on intestinal flora,gastrointestinal function,inflammatory indexes and prognosis of elderly patients with severe acute cerebral infarction.Methods A total of 128 elderly patients with severe acute cerebral infarction who were admitted to the hospital from January 2020 to December 2021 were randomly divided into observation group(n=64)and control group(n=64).After enrollment,all patients received ECG monitoring and conventional symptomatic treatment.On this basis,the control group received enteral nutrition support with probiotics,and the observation group received enteral nutrition support with probiotics and treatment with rhubarb.Both groups were treated continuously for 4 weeks.The intestinal flora,gastrointestinal function,inflammatory indexes and prognosis of the two groups were compared before and after treatment.Results The differences in the counts of bifidobacteria,lactobacilli,Enterococcus and Escherichia coli before and after treatment between the two groups were statistically significant(all P<0.001).The differences in the levels of calcitonin gene-related peptide,motilin,interleukin-6,C-reactive protein,tumor necrosis factor-αbefore and after treatment between the two groups were statistically significant(all P<0.001).The difference in the National Institutes of Health Stroke Scale score before and after treatment between the two groups was statistically significant(P<0.001).Conclusion Rhubarb combined with probiotics may improve the prognosis of elderly patients with severe acute cerebral infarction by maintaining the balance of intestinal flora,restoring gastrointestinal function and relieving inflammatory reaction.